DEVELOPMENT AND VALIDATION OF QUALITY OF LIFE SCALE FOR PEOPLE LIVING WITH HIV

methodological study conducted in a Brazilian care service specialized in sexually transmissible infections/AIDS between 2017 and 2019 addressing people living with HIV. The scale’s development and validation included exploratory factor analysis to describe its factor structure and psychometric properties, Multitrait-Multimethod analysis to verify its validity and Cronbach’s alpha for reliability. Floor and ceiling effects were described according to the responses’ frequency distribution.

Results:

a total of 460 people living with HIV participated. Most were men 276 (60.0%) aged 43 on average (SD=±12.4). The Exploratory Factor Analysis revealed four factors with 39.9% of explained variance. The total scale presented satisfactory reliability with a Cronbach’s alpha equal to 85.0%. Most items presented satisfactory convergent and divergent validity. The presence of floor and ceiling effects were found. The scale’s final version was composed of 45 items.

Conclusion:

the Quali-HIV Scale is a valid and reliable tool to measure the quality of life of people living with HIV.

DESCRIPTORS:
HIV. Quality of life. Surveys and questionnaires. Validation studies. Psychometrics. Weights and measures. Chronic disease. Antiretroviral therapy; highly active

Variables		Total
Variables		N	%
How long the individual was aware of the HIV infection (years)	< 2	105	22.8
	2 to5	64	13.9
	> 5	291	63.3
TCD4+ lymphocytes (mm³/blood)	≤ 350	54	11.7
	351 to 500	85	18.5
	>500	321	69.8
Viral load (copies/ml)	Undetectable (≤ 40)	397	86.3
	<10,000	37	8.1
	10,000 to 100,000	19	4.1
	>100,000	07	1.5
Comorbidities	No comorbidities	273	59.3
	One comorbidity	115	25.0
	Two or more comorbidities	72	15.7
Co-infection	No co-infection	402	87.4
Co-infection	Co-infection	58	12.6

Total variance explained
F	Initial eigenvalues			Extraction Sums of Squared Loadings			Rotation Sums of Squared Loadings
	Total	%*	%†	Total	%*	%†	Total	%*	%†
1	8.76	17.17	17.17	8.76	17.17	17.17	6.86	13.46	13.46
2	4.56	8.93	26.11	4.56	8.93	26.11	3.06	6.01	19.46
3	3.03	5.93	32.04	3.03	5.93	32.04	2.66	5.22	24.68
4	2.25	4.42	36.46	2.25	4.42	36.46	2.52	4.93	29.61
5	1.88	3.70	40.15	1.88	3.70	40.15	2.28	4.48	34.09
6	1.60	3.14	43.30	1.60	3.14	43.30	2.18	4.27	38.36
7	1.50	2.94	46.23	1.50	2.94	46.23	1.96	3.85	42.21
8	1.46	2.87	49.11	1.46	2.87	49.11	1.63	3.19	45.40
9	1.38	2.72	51.82	1.38	2.72	51.82	1.59	3.13	48.52
10	1.33	2.60	54.42	1.33	2.60	54.42	1.59	3.11	51.63
...	...	...	...	...	...	...	...	...	...
51	0.18	0.35	100.00

Rotated Component Matrix
Scale’s items	Factors
Scale’s items	1	2	3	4
Item 1		.673
Item 3		.672
Item 4		.381
Item 5		.401
Item 11		.437
Item 12				.488
Item 13	.453
Item 14	.373	.360
Item 15		.401
Item 16		.342
Item 17	.541
Item 20		.482
Item 21	.403	.334
Item 23		.391
Item 29	.388
Item 32		.413
Item 33		.469
Item 37	.486	.373
Item 46			.836
Item 47			.814
Item 48			.760
Item 50	.382
Item 51				.534
Item 2*R	.621
Item 6*R	.326
Item 7*R	.320
Item 18*R	.648
Item 19*R				.411
Item 22*R	.464
Item 24*R	.381	-.324		.495
Item 25*R	.619
Item 26*R	.478	-.426
Item 27*R				.565
Item 28*R	.713
Item 30*R	.678
Item 31*R	.330
Item 34*R	.304
Item 35*R	.440
Item 36*R	.746
Item 38*R	.463	-.323
Item 39*R	.522
Item 40*R	.540
Item 43*R	.741
Item 44*R	.631
Item 49*R	.622
Eigenvalues	8.54	4.42	2.93	2.09
Variance explained (%)	18.98	28.79	35.30	39.95
Cronbach’s alpha	0.90	0.75	0.86	0.70

Item	Mean	Standard deviation	Factor				Total
Item	Mean	Standard deviation	F1	F2	F3	F4	Total
Item 13	3.64	1.34	0.16	0.23	0.01	0.01	0.23
Item 14	4.04	1.17	0.31	0.25	-0.05	0.11	0.39
Item 17	4.52	0.98	0.46	0.01	0.20	0.11	0.45
Item 21	3.75	1.08	0.55	0.9	0.8	0.32	0.59
Item 29	2.86	1.37	0.34	0.01	-0.01	0.26	0.36
Item 37	3.85	1.11	0.47	0.22	0.07	0.13	0.53
Item 50	3.41	1.32	0.22	0.16	-0.04	-0.08	0.23
Item 02	4.50	1.00	0.51	0.07	0.05	0.18	0.51
Item 06	4.43	1.16	0.54	-0.16	0.20	0.18	0.46
Item 07	4.62	0.83	0.47	-0.03	0.18	0.20	0.46
Item 18	4.10	1.39	0.57	-0.24	0.26	0.24	0.48
Item 22	4.37	1.08	0.55	-0.29	0.00	0.24	0.41
Item 25	4.34	1.14	0.62	-0.08	0.4	0.34	0.58
Item 26	3.53	1.41	0.48	-0.37	0.08	0.34	0.35
Item 28	4.52	0.93	0.69	-0.01	0.01	0.20	0.63
Item 30	4.01	1.26	0.71	-0.16	0.06	0.28	0.60
Item 31	3.60	1.48	0.41	-0.25	-0.06	0.30	0.32
Item 34	3.80	1.45	0.40	-0.23	-0.10	0.39	0.33
Item 35	4.04	1.27	0.46	-0.04	0.12	0.07	0.41
Item 36	4.32	1.14	0.76	-0.17	0.10	0.34	0.66
Item 38	3.85	1.42	0.52	-0.26	0.23	0.18	0.41
Item 39	4.02	1.34	0.59	-0.20	0.26	0.24	0.50
Item 40	4.38	1.12	0.45	0.08	0.14	0.03	0.44
Item 43	4.21	1.13	0.73	-0.11	0.15	0.27	0.66
Item 44	4.55	0.99	0.46	-0.15	0.13	0.34	0.43
Item 49	3.15	1.37	0.64	-0.02	0.05	0.34	0.62
Item 01	3.56	1.38	0.08	0.56	-0.10	-0.09	0.23
Item 03	3.58	1.35	-0.01	0.62	-0.20	-0.06	0.16
Item 04	2.15	1.41	-0.05	0.37	-0.20	0.05	0.07
Item 05	4.72	0.67	0.17	0.12	0.07	0.03	0.21
Item 11	2.60	1.53	0.10	0.46	0.03	-0.05	0.24
Item 15	4.79	0.43	-0.15	0.47	-0.18	-0.22	-0.03
Item 16	4.57	0.89	-0.05	0.19	-0.05	-0.01	0.02
Item 20	2.95	1.24	0.00	0.56	0.03	0.07	0.21
Item 23	3.14	1.39	-0.30	0.44	-0.02	-0.17	-0.15
Item 33	3.03	1.48	-0.15	0.35	-0.06	-0.07	-0.03
Item 32	3.44	1.47	-0.34	0.45	-0.15	-0.14	-0.19
Item 46	4.64	0.68	0.25	-0.04	0.70	-0.10	0.24
Item 47	4.39	1.09	0.06	-0.11	0.59	-0.09	0.03
Item 48	4.63	0.75	0.09	-0.19	0.60	-0.08	0.04
Item 12	1.87	1.23	0.18	0.17	-0.18	0.46	0.28
Item 51	2.37	1.19	0.24	-0.09	0.04	0.46	0.27
Item 19	4.05	1.32	0.12	0.13	-0.16	0.04	0.15
Item 24	3.43	1.56	0.43	-0.26	0.02	0.46	0.37
Item 27	3.02	1.43	0.25	-0.22	-0.08	0.62	0.23

	Factors
	F1		F2		F3		F4		Total
	N	%	N	%	N	%	N	%	N	%
-2	00	0	0	0	00	0	00	0	00	0
-1	01	1.3	1	3.0	00	0	03	20.0	05	3.7
1	14	17.9	8	24.2	00	0	01	6.7	23	17.0
2	63	80.8	24	72.7	09	100.0	11	73.3	107	79.3
1+2	77	98.7	32	97.0	09	100.0	12	80.0	130	96.3
Goodness of fit	100%

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Maria Cristina Mendes de Almeida Cruz macris-almeida@hotmail.com